2014-08-19 11:36:46 +00:00
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<form model="clinic.patient">
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<head>
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<field name="state"/>
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<button string="Options" dropdown="1">
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<item string="Send Confirm visit"/>
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</button>
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</head>
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<tabs>
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2014-09-30 11:17:46 +00:00
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<tab string="Patient's Data">
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<group span="12" colunm="1">
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<field name="type"/>
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</group>
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<group span="12" colunm="1">
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<field name="number"/>
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<field name="date"/>
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</group>
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<group span="12" colunm="2">
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<field name="first_name"/>
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<field name="last_name"/>
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</group>
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<group span="12" colunm="2">
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<field name="birthday"/>
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<field name="age"/>
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</group>
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<group span="12" colunm="2">
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<field name="card_type"/>
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</group>
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<group span="12" colunm="2">
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<field name="iden_id"/>
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<field name="exp_id"/>
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</group>
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<field name="telephone"/>
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<field name="mobile"/>
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<field name="gender" span="12"/>
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<field name="marital_status" span="12"/>
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<group span="12" colunm="2">
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<field name="nationality"/>
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<field name="race"/>
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</group>
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<field name="graduation" span="12"/>
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<field name="job" span="12"/>
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<field name="weight" span="12"/>
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<field name="height" span="12"/>
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</tab>
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<tab string="Patient's Data +">
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<field name="smoke" span="12"/>
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<field name="salary" span="12"/>
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<field name="withdrawal" span="12"/>
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<group span="12" colunm="2">
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<field name="first_hemodialysis"/>
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<field name="hemodialysis"/>
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</group>
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<field name="first_treatment" span="12"/>
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<group span="12" colunm="2">
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<field name="clinic_after"/>
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<field name="clinic_after_name"/>
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</group>
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<field name="first_permanent_vascular_access" span="12"/>
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<field name="first_tenckhoff_catheters" span="12"/>
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<field name="start_date_clinic" span="12"/>
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<field name="waiting_transplantation" span="12"/>
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<field name="who_transplantation"/>
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<field name="reason_of_chronic_renal_failure"/>
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<separator string="Cause of chronic renal failure"/>
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<group span="12" colunm="3">
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<field name="ac_mi"/>
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<field name="co_an"/>
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<field name="ce_ac"/>
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<field name="hypertnsion"/>
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<field name="dia"/>
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<field name="copd"/>
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<field name="asthma"/>
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<field name="pul_tub"/>
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<field name="cancer"/>
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<field name="cirrhosis"/>
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<field name="dyslip"/>
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<field name="prca"/>
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<field name="hyperucemia"/>
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<field name="cga"/>
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<field name="parathy"/>
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</group>
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</tab>
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2014-10-01 04:05:52 +00:00
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<tab string="Co-marbid">
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<separator string="Co-morbidity, before RRT"/>
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<field name="check1" span="12"/>
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<field name="check2" span="12"/>
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<field name="check3" span="12"/>
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<field name="check4" span="12"/>
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<field name="check5" span="12"/>
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<field name="check6" span="12"/>
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<field name="check7" span="12"/>
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<field name="check8" span="12"/>
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<field name="check9" span="12"/>
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<field name="check10" span="12"/>
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<field name="check11" span="12"/>
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<field name="check12" span="12"/>
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<field name="check13" span="12"/>
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<field name="check14" span="12"/>
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<field name="check15" span="12"/>
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<field name="check16" span="12"/>
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<field name="check17" span="12"/>
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2014-09-30 11:17:46 +00:00
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</tab>
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<tab string="Morbidity">
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2014-10-01 04:05:52 +00:00
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<separator string="Morbidity, After RRT"/>
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<field name="check18" span="12"/>
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<field name="check19" span="12"/>
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<field name="check20" span="12"/>
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2014-09-30 11:17:46 +00:00
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<field name="comarbid2"/>
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</tab>
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<tab string="Healthcare">
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<field name="doctorsss"/>
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<field name="nurses"/>
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</tab>
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2014-08-19 11:36:46 +00:00
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</tabs>
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<related>
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<field name="addresses"/>
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</related>
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<related>
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<field name="visits"/>
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</related>
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2014-08-21 07:29:37 +00:00
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<related>
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<field name="hd_cases"/>
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</related>
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2014-08-19 11:36:46 +00:00
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<related>
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<field name="comments"/>
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</related>
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</form>
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